Healthcare Provider Details

I. General information

NPI: 1639258684
Provider Name (Legal Business Name): KARL ERIC FIELD PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HEALTH UNIT AMERICAN EMBASSY GHANA 2020 ACCRA PL
WASHINGTON DC
20521-2020
US

IV. Provider business mailing address

2020 ACCRA PL
DULLES VA
20189-2020
US

V. Phone/Fax

Practice location:
  • Phone: 202-663-1662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2993
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: